High HIV risk in a cohort of male sex workers from Nairobi, Kenya.
Sex Transm Infect
; 90(3): 237-42, 2014 May.
Article
em En
| MEDLINE
| ID: mdl-24337729
ABSTRACT
OBJECTIVES:
Men who have sex with men (MSM) are at high risk of HIV-1 acquisition and transmission, yet there remains limited data in the African context, and for men who sell sex to men (MSM SW) in particular.METHODS:
We enrolled 507 male sex workers in a Nairobi-based prospective cohort study during 2009-2012. All participants were offered HIV/STI screening, counselling and completed a baseline questionnaire.RESULTS:
Baseline HIV prevalence was 40.0% (95% CI 35.8% to 44.3%). Prevalent HIV infection was associated with age, less postsecondary education, marijuana use, fewer female partners and lower rates of prior HIV testing. Most participants (73%) reported at least two of insertive anal, receptive anal and insertive vaginal sex in the past 3 months. Vaginal sex was reported by 37% of participants, and exclusive MSM status was associated with higher HIV rates. Condom use was infrequent, with approximately one-third reporting 100% condom use during anal sex. HIV incidence was 10.9 per 100 person-years (95% CI 7.4 to 15.6). Predictors of HIV risk included history of urethral discharge (aHR 0.29, 95% CI 0.08 to 0.98, p=0.046), condom use during receptive anal sex (aHR 0.05, 95% CI 0.01 to 0.41, p=0.006) and frequency of sex with male partners (aHR 1.33/sex act, 95% CI 1.01 to 1.75, p=0.04).CONCLUSIONS:
HIV prevalence and incidence were extremely high in Nairobi MSM SW; a combination of interventions including increasing condom use, pre-exposure prophylaxis and access to effective treatment is urgently needed to decrease HIV transmission in this key population.Palavras-chave
Texto completo:
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Base de dados:
MEDLINE
Assunto principal:
Parceiros Sexuais
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Infecções por HIV
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Saúde Pública
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Preservativos
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Homossexualidade Masculina
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Transtornos Relacionados ao Uso de Substâncias
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Profissionais do Sexo
Tipo de estudo:
Etiology_studies
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Observational_studies
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Prevalence_studies
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Prognostic_studies
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Qualitative_research
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Risk_factors_studies
Limite:
Adult
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Humans
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Male
País como assunto:
Africa
Idioma:
En
Ano de publicação:
2014
Tipo de documento:
Article